LIFE IN THE END ZONE: A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD

September 24, 2017

A Day to Shout

This
past week was Rosh Hashanah, the Jewish New Year. I discussed the origins and
evolution of the holiday at my synagogue, observing that the original name of
the holiday, as indicated in the Torah, the Jewish bible, is “The Day of
Shouting.” And what was it that people were supposed to shout about?
Originally, they were supposed to shout out their praise of God. Some of the
admirable qualities that have been attributed to God are “caring for widows and
orphans,” which is biblical shorthand for “caring for the vulnerable,” and “welcoming
the stranger, for you were strangers in the land of Egypt,” which is synonymous
with accepting outsiders, newcomers into the community. But already early on in
Jewish history, and particularly over the last several hundred years, the
tradition is that these “attributes of God” are seen as aspirational—as qualities
that people should strive to emulate in their own lives. So, translating into
contemporary language, on Rosh Hashanah, we are supposed to strive to care for
the poor and the sick and to open our doors to refugees.

But there’s more. Over the centuries, not only have these qualities attributed to God become qualities that people should strive to adopt themselves, but it has also become our responsibility to act. The
shouting that we are supposed to do on Rosh Hashanah is not so much singing God’s
praises as it is calling out to our fellow man to act. And the actions in
question, not surprisingly, include caring for the poor and the sick and embracing
refugees.

The health care bill that is expected
to come to the Senate floor this week is the very epitome of how to avoid
caring for the poor and the sick. If you cannot afford medications, hospital
care, or insurance premiums—that’s your fault. Next time, work harder, go to
better schools or, better yet, choose parents who are themselves smart,
educated, and affluent so they can assure that you, too, will be smart,
educated, affluent—and able to afford to pay whatever it costs to get good
care. In fact, if you have cancer or diabetes or some other chronic, serious condition,
that’s your fault, too, so why should someone else have to subsidize your
treatment? This bill, which pretends to include benefits comparable to those
currently available under the Affordable Care Act, is not a means of providing
health insurance to all those left out by the three other programs for
obtaining coverage: Medicaid, Medicare, and employer-supported insurance.
Rather, it is a strategy to gut Medicaid, one of the three pillars of the
current system. The ACA was designed to take a three-legged stool and enhance
its stability by adding a fourth leg; the latest travesty proposed by Senate
Republicans would instead amputate one of the three legs. So, here’s my shout
out to my fellow Americans: say “no” to the Senate proposal. Shout out to your
senators—especially if you’re from one of those states such as Maine and Alaska
whose senators have previously expressed concern about the poor and the sick in
their states, or if you’re from one of the states that stands to lose the most
from the new bill, such as Florida and Nevada. Shout to those people you know
who live in those states that they should shout out to their senators. Make
this Rosh Hashanah truly the “Day of Shouting.”